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Pt with PFpathy advised to have knees slightly flexed when standing; what about soloeus

Discussion in 'Biomechanics, Sports and Foot orthoses' started by markjohconley, Jul 13, 2018 at 11:46 AM.

  1. markjohconley

    markjohconley Well-Known Member


    Members do not see these Ads. Sign Up.
    I was listening to a physiotherapy podcast with an 'ankle and foot' clinician being interviewed.
    At one time he stated he advises his plantar fasciopathy patients, when standing, to slightly flex their knees to reduce load from the 'calf' to the plantar fascia (PF).
    I easily believe it for the gastrocnemius components of the achilles tendon (AT) but would not there be an increase in load in the soleus component of the AT?
    Or is the load applied to the PF from the soleus far less significant?
    thanks, mark
     
  2. efuller

    efuller MVP

    Assuming that there is adequate range of motion, the tension in the Achilles will be determined by balance. By adequate range of motion I mean the Achilles stiffens at greater than ( an arbitrary) 10 degrees of dorsiflexion. To balance in the upright position the center of mass has to be over the center of pressure under the foot. When you lean forward, you have to increase tension in the Achilles to shift the center of pressure forward. So, instead of bending the knees, the advice should be to lean back on your heels when you have to stand for prolonged periods of time. You can lean forward, or backward, with your knees bent.

    Eric
     

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